Abstract: An ultrasonic surgical instrument has a shaft and a probe head, the shaft and the probe head have a lumen or channel and a longitudinal axis and the probe head having a distal end face. The probe head has at least one operative surface engageable with organic tissues for the application of ultrasonic vibratory energy to the tissues. The end face is oriented at least partially transversely to the axis. The lumen or channel has a first outlet opening in the end face and at least one second outlet opening in a lateral surface of either the shaft or the probe head at a position spaced from the end face. The probe head has a plurality of teeth extending laterally from the end face, in two rows on opposing side of the end face.

Abstract: An adjusting and cutting tool including a distal end engageable with an elongate portion of an implantable article to facilitate manipulation of the elongate portion relative to a support portion of the implantable article and to facilitate cutting of the elongate portion. Also included is method of treating vaginal prolapse, the method including the steps of providing a multi-piece implantable article having at least one extension portion piece and a support portion piece, placing the support portion piece in contact with vaginal tissue, placing at least one extension portion piece in contact with tissue of a component of sacral anatomy, adjusting a position of the at least one extension portion piece relative to the support portion piece using a adjusting and cutting tool, and cutting the at least one extension portion with the adjusting and cutting tool.

Abstract: Surgical and percutaneous devices for closing tissue, for example, the left atrial appendage, may have an elongate body with a stiffened proximal portion, a flexible middle portion, a distal portion, a closure element with a loop having a continuous aperture therethrough, and a suture loop. The closure devices may have a malleable member attached to the elongate body that may be configured to retain a curve after a force is applied to the malleable member. System and methods for closing the left atrial appendage may utilize a closure device and a curved guide device, and the closure device and curved guide device may be self-orienting.

Abstract: An introducer assembly can be releasably coupled to a surgical instrument and includes a collar, a tip, and an elongated body portion disposed between the collar and the tip. The tip may be configured to releasably engage a dissecting device. The collar may releasably couple the introducer assembly to a shaft of a surgical fastener applying apparatus. The tip may have an opening to receive a distalmost end of an end effector of a surgical fastener applying apparatus.

Abstract: A suturing instrument includes a suturing head that is coupled to the shaft of an elongate body member of the instrument by a connector member which may be biased in either a linear orientation along the longitudinal axis of the shaft or any one of a variety of non-linear orientations with respect to the shaft's longitudinal axis. The connector member can comprise a resilient material such that an external force may be applied to the suturing head and move the suturing head from a biased orientation (e.g., linear) to an unbiased orientation (e.g., non-linear). Once the external force is removed, the resiliency of the connector member allows the suturing head to return from the unbiased orientation to the biased orientation. Therefore, a user may adjust the shape of the instrument by applying or removing an external force on the suturing head.

Abstract: Described are medical graft materials and devices which can be usefully modified with liquid additives such as cell suspensions, bioactive agents, or combinations of these. The medical graft materials and devices can have a first outer surface and a second outer surface and can define an internal chamber between the first outer surface and the second outer surface. The medical graft materials and devices can also have at least one region of the graft material interrupting the chamber and surrounded by the chamber. Also described are methods for making and using these medical graft materials and devices.

Abstract: A long articulating steerable clip applier affixed to a user-operated handle. A surgical jaw assembly is attached to the other end of the clip applier. The clip applier is composed of articulating phalanges that are connected end to end by pivoting links and capable of angulations relative to one another when subjected to a tensile force. Each phalange has opposing s-shaped exterior grooves that form two continuous spiral-shaped channels for holding tension wires once the phalanges are assembled. Multiple tension wires are attached to opposite ends of adjacent phalanges. When each wire is pulled, this tensile force causes the phalanges to pivot at equivalent angles with each other. As each individual phalange pivots by an equivalent angle, the sum of these angles causes the free end of the clip applier to pivot by a large angle or a cascading actuation effect.

Abstract: In first and second embodiments the device comprises a generally cylindrically shaped body distal end and a proximal end, and is conformed to be received by a fingertip of a medical practitioner. A conical shaped cap is defined at the distal end with a plurality of metal protrusions for debridement scrapping formed on an outer surface, and along a bottom surface of the body. In the alternative second embodiment, a curette styled loop blade with a cutting edge is formed on the bottom surface. A third embodiment does not have the cap and has debridement scrapping protrusions defined along the bottom surface. Straps are attached to the body to secure the device to any finger of a medical practitioner.

Abstract: An occlusion clamp including: (a) an occlusion tongs including a primary spring coupling a first longitudinal arm to a second longitudinal arm, the first longitudinal arm including a first linear occlusion surface configured to be parallel to and overlap a second linear occlusion surface of the second longitudinal arm, each of the first and second longitudinal arms having a free distal end; and, (b) a secondary spring removably coupled to the occlusion tongs.

Abstract: A device for repositioning an implant within a lumen of a subject including (a) a catheter having forward and rearward ends and a collapsible and expansible stop element mounted adjacent the forward end of the catheter, the stop element being adapted to engage a wall of the lumen when expanded and to provide one or more passages extending from a rear side of the stop element to a forward side of the stop element when the stop element is expanded and engaged with the wall of the lumen and (b) one or more snares, each snare having engagement features, the stop element and the snares being constructed and arranged so that the snares can be positioned extending through the one or more passages with their engagement features forward of the stop element.

Abstract: A device for making continuous suture stitches including a handle and a device head. The handle including a power source for the device head and a means for attachment to the device head. The device head including a suture thread supply; a needle rotationally movable, operable for moving the thread through a tissue; a hook operable for hooking and lifting the thread in automatic coordination with the needle; and a catcher operable for moving the thread into and out of the hook in automatic coordination with the hook; thereby providing a device for making continuous suture stitches for adjoining a first edge and a second edge of a tissue in an edge-to-edge interface.

Abstract: The present invention relates generally to a method and apparatus for deploying and/or retrieving a vena cava filter in a vena cava using a system configured to: (i) maintain grip of the unsheathed filter in the vena cava until deliberately released, (ii) prevent premature release of the filter in the vena cava, and/or (iii) facilitate retrieval by first everting the filter, then withdrawing the filter through a guiding catheter (e.g., retrieval via eversion).

Abstract: A medical instrument including a first joint including a first member and a second member, the first member configured to be repositionable with respect to the second member in a first degree of freedom, a second joint operatively coupled to the first joint, the second joint including a third member and a fourth member, the third member configured to be repositionable with respect to the fourth member in a second degree of freedom, a pair of repositionable jaws operatively coupled to the first joint and the second joint, an open-ended occlusion clip detachably mounted to the pair of repositionable jaws, and a controller operatively coupled to the first joint, the second joint, and the pair of repositionable jaws, the controller including a control with a line operatively coupled to the first and second jaws in at least a gun tackle pulley configuration.

Abstract: Devices and methods for the controlled over-expansion of a body conduit and controlled constriction or expansion of a vessel in a patient are disclosed. The devices and methods can employ a bio-corrodible expandable support structure and an implant coaxially adjacent the support structure. The support structure can have a delivery diameter and an expanded supporting diameter. The implant can have a collapsed deformed diameter, an undeformed neutral diameter and an over-expanded deformed diameter. Contraction of the implant can occur when the support structure is bioabsorbed.

Abstract: A surgical apparatus includes an elongate outer sheath dimensioned for positioning within a body lumen of a patient, a reference member and a removal device. The reference member is adapted for longitudinal movement relative to the elongate outer sheath between a first position at least partially disposed within a longitudinal lumen of the outer sheath and a second position at least partially exposed from the longitudinal lumen. The reference member is adapted to expand when in the second position to generally conform to an internal dimension of the body lumen. The reference member includes a radiopaque material for visualizing the reference member to assist in determining physical characteristics of the body lumen when in the second position. The removal device is adapted for longitudinal movement relative to the reference member, and is configured for disrupting at least a portion of the occlusion within the body lumen.

Abstract: Methods and apparatuses for regulating aortic regurgitation are provided. A catheter shaft is advanced through vasculature so that a flexible occluding membrane coupled to the catheter shaft is positioned within the aorta, typically the ascending aorta above the Sinus of Valsalva and coronary ostia. Blood flow in the aorta causes the flexible occluding membrane to alternate between an expanded occluding configuration while in diastole and a collapsed lesser occluding configuration is systole. There flexible occluding membrane thereby acts as a temporary aortic valve. The flexible occluding membrane is generally conical in shape, with the tip of the cone disposed closer to the aorta than the proximal rim. In diastole, blood flow expands the flexible occluding membrane so that the proximal rim apposes the inner wall of the aorta. The flexible occluding membrane will have one or more openings to allow perfusion of the coronary arteries in diastole.

Abstract: Provided is an automatic hair transplanter for transplanting follicles including a housing having a space therein and having an aperture in a front surface, a cartridge installed behind the aperture and having a plurality of holes containing each of needle and rod assemblies, a cartridge driver configured to sequentially cause centers of the needle and rod assemblies to correspond to the center of the aperture by causing the cartridge to make a rectilinear motion or a rotary motion, a needle-and-rod assembly pressurizer configured to pressurize the back end of a needle and rod assembly whose center corresponds to the center of the aperture, and a manipulator having a switch for controlling operations of the cartridge mover and the needle-and-rod assembly pressurizer.

Abstract: An operation support device includes a connecting body in which a first support body and a second support body are detachably connected to each other; a first shaft engaging section; a shaft connecting member having a connection engaging section engaged with the first shaft engaging section; and a shaft fixing member. The shaft fixing member is movably installed with respect to a first shaft section or a second shaft section and is configured to selectively form a shaft engagement fixing state in which the connection engaging section is held down to retain an engagement state such that the connection engaging section is engaged with the first shaft engaging section and a second state in which holding down to the connection engaging section is released in accordance with a moved position with a moved position of the shaft fixing member.

Abstract: A sizing tool for use in implanting a composite valved conduit having a prosthetic heart valve on a distal end attached to a conduit graft that extends to a proximal end. The tool includes a proximal handle and a distal shaft, a prosthetic heart valve sizer having an axis affixed to a distal end of the shaft, and a conduit graft replica having an axis mounted on the shaft proximal to the heart valve sizer. A method of securing a composite valved conduit includes introducing to an excised ascending aorta the sizing tool, measuring the aortic annulus with the prosthetic heart valve sizer, and determining whether the coronary arteries have sufficient length or whether an additional tubular coronary extension segment is required to add to one or both of the ends of the coronary arteries by extending the coronary arteries toward the conduit graft replica.

Abstract: A method for positioning an electrode array of a neuromodulation catheter at a target circumferential position along a posterior wall of a superior vena cava includes advancing the catheter to a target longitudinal position within the superior vena cava, and orienting a marker on the extracorporeal portion of the catheter in a circumferential orientation known to position the array at the target circumferential position along the posterior wall. A method of positioning the array at a target longitudinal position includes advancing the catheter into the superior vena cava and using features of the catheter to detect the location of right atrial tissue, such as by sensing for a P-wave using an electrogram captured using an electrode carried at a distal end of the catheter, or by using such electrodes to capture the atrium using atrial pacing pulses. Once the location of the right atria is determined, the electrode array may be deployed in a position known to be proximal to the atrium.